Individual
GREGORY DETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 RICHMOND AVE E, MATTOON, IL 61938-4652
(217) 234-7000
(217) 238-5484
Mailing address
1005 HEALTH CENTER DR STE 201, MATTOON, IL 61938-4693
(217) 234-6055
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-087539
IL
Other
Enumeration date
08/21/2006
Last updated
09/21/2018
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